The global maternal health workforce comprises care providers with different skillsets who practice in diverse contexts, including physicians, midwives, nurses, community health workers and others. The “Global strategy on human resources for health: Workforce 2030” report estimated the global health workforce shortage at roughly 17.4 million providers as of 2013, of which nine million were nurses and midwives. The authors of the report noted that most countries are not on track to reach a threshold of 4.45 physicians, nurses and midwives per 1,000 people, which will be necessary for accomplishing the health-related SDG targets by 2030. Additionally, the health workforce tends to be concentrated in cities, leaving women in rural areas with limited access to skilled care.

Shortages in the workforce can have dire consequences for maternal health outcomes. One analysis found that countries with higher densities of surgeons, anesthesiologists and obstetricians had significantly lower maternal mortality ratios. Researchers who modeled the projected effects of scaling-up midwifery predicted that a 10% increase in coverage of midwifery-led care would result in a 27% reduction in maternal mortality in low-income countries. Task-sharing and task-shifting are two strategies to manage health worker shortages. Studies from several countries have had success expanding the scope of work of mid-level providers or training community health workers to deliver a number of services such as breastfeeding and immunizations education, safe abortion care and intermittent preventive treatment for malaria. Researchers in Malawi, Mozambique and Tanzania found that medical officers were able to perform safe cesarean section surgery when properly trained. Ensuring that all health workers receive high quality education and pre-service training—and that the health system in which they work has the capacity to administer supportive supervision, opportunities for continuing education and operational management—is essential to improve maternal health.

An effective maternal health workforce requires not only a sufficient number of workers, but also equitable geographic distribution, diversity in skill, adequate education and training and strong, supportive health systems. All of these components are critical to ensure that health workers are willing and able to provide high quality maternal health care.

MATERNAL HEALTH TASK FORCE

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant T76MC00001 and entitled Training Grant in Maternal and Child Health. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.